Posts for tag: TMD

STRESS! You see it, you feel it, everyone seems to have it – some days more than others, right? That tension you experience finds its way to so many parts of your body, sometimes without your awareness, and sometimes it’s screaming at you. The tightness! The aches! The pains! For many, the discomfort lands in the head, neck, shoulders, jaws, -- and a place that is often overlooked -- the teeth.

Dr. Matthew Messina, a consumer adviser for the American Dental Association, says, “Stress, whether it’s real or perceived, causes flight-or-flight hormones to release in the body. Those released stress hormones mobilize energy, causing isometric activity, which is muscle movement, because that built-up energy has to be released in some way.” That energy may be exhibited in tooth clenching or grinding.

We often see the results of tension and stress as wear on teeth due to clenching and grinding. When we suggest that to people almost everyone tells us they don’t do it, or aren’t aware that they do it. So we suggest that they might notice how their mouth feels when they wake up in the morning; do they feel any tightness or soreness around their temples, jaws, or muscles in their face? Or when they are concentrating at the computer do they notice holding their teeth tightly together? What about the next time they are feeling angry? What’s happening with their jaw? Are they athletes? What about when they are weight lifting for strength training, or on that uphill climb on their bikes? Yep! The next time those folks are reporting, “you know, I catch myself holding a lot tension in my mouth; I find that my teeth are clenched tightly together.” Or “when I wake up in the morning, before I open my eyes, I checked and my jaws were feeling tight and sore – I must be doing that in my sleep!”

So then we need to consider the damage that this stress causes in the mouth, on the teeth, jaws, and muscles of the head and neck. We see this leading to major tooth wear and damage, or causing very sore muscles. Over time it can even lead to wear and damage to the temporomandibular joints (the TMJs), the jaw joints that are located in front of your ears.

Consider this: Dr. Robert Rawdin, a Manhattan prosthodontist, notes that when we chew we “normally exert about 20 to 30 pounds per square inch on our back molars.” As if that isn’t enough force on our teeth, he adds, “teeth grinders, especially at night without restraint, can exert up to as much as 200 pounds per square inch on their teeth.” Just think about how much damage that amount of force can create! For some people the damage is localized to extensive wear or broken or chipped teeth. For others, the muscles or jaw joints take the damage.

While the damage and wear that grinding creates can often be repaired, a far better approach is to prevent it from occurring in the first place. Most grinding and clenching creates some warning signs before the damage is extensive. Regular dental check-ups allow your dentist to monitor those signs to determine if problems are occurring before major damage is the result. And if your dentist determines that there may be a concern, it’s time for you to take steps to prevent further problems.

The first step is often to listen to your body. By choosing to integrate and practice things such as mindfulness, meditation, relaxation and yoga, people can first realize where the tension in their bodies is building up and then learn techniques to eliminate it. Some signs that you may be clenching or grinding your teeth are headaches, over-sensitive teeth, sore facial muscles, jaw pain, flat or sharp teeth, and/or damage or soreness on the inside of your cheeks.

By becoming aware of your patterns and learning to relax your jaw and those muscles, you can prevent problems before they become severe enough to require extensive dental treatment. It’s true: prevention, like honesty, IS the best policy!

My day spent with Dr. Jeffrey Okeson at the Chicago Midwinter Dental Meeting last week was fascinating and helpful. He is the Director of the Orofacial Pain Program at the University of Kentucky College of Dentistry and has a very extensive academic background with a deep knowledge of research. As a result, I respect his opinions and information. And, as is often true at least for me, I resonated with him because I agree with his point of view.

Of the six hours of Dr. Okeson's presentation, he spent half of his time discussing current concepts in the causes of tempromandibular (the jaw joint known as the TMJ) disorders (referred to as TMD) that result in pain. He then reviewed various philosophies in dentistry and options for treatment in the other half of his presentation. He described five different treatment approaches based on the desired outcome for how the teeth fit and how the jaw works. This has become a very controversial topic in our profession, and treatment approaches widely vary--particularly as it pertains to the amount of treatment that is recommended in the different approaches.

I was delighted to learn Dr. Okeson's perspective is congruent with what I have learned over my years of study at the L.D. Pankey Institute. There I received ongoing post-graduate education in the area of restoring teeth to health and with attaining healthy jaw joint function.

Our approach has been research based and experience driven. We have had a great deal of success with our individualized approach, helping identify contributing habit patterns, counseling on options, and utilizing the 'less is more' philosophic approach that Dr. Okeson affirmed.

I especially smiled at Dr. Okeson's closing comments where he encouraged everyone to treat their patients in the same way that they would want their children, spouses, or parents treated - and that's the way we do it at Kuttler Dental!